The NICU Translated Podcast

Mary Farrelly (00:00)
The is often a place of miracles.

but can also be a place of unimaginable heartbreak. When a family experiences loss in the NICU, the care they've received in those moments can shape their healing for years to come. My guest today, Ashley Inclima, is a perinatal loss and bereavement doula who specializes in supporting families through pregnancy, birth, and infant loss. She's here to share how we can improve the bereavement experience for NICU families with compassion, presence, and care that honors both the baby and the parent's journey.

Mary Farrelly (01:01)
Hi everyone and welcome back to this week's episode of the NICU Translated Podcast. I'm so excited to have Ashley Inclima on today and we are going to be talking about a topic that is near and dear to both of our hearts, which is supporting loss and grief in the NICU setting. So I am so excited to have you here today and have you share about this really underserved and unique area of NICU care and support. So welcome to the show.

Ashley Inclima (01:30)
Thank you so much, Mary. I'm so excited to be talking with you today.

Mary Farrelly (01:33)
Me too. feel like sometimes, you know, there's just a full spectrum of ways to support a NICU family. And this topic is one that doesn't always get enough spotlight or conversation, and it

leave people who support NICU families and NICU professionals feeling really confused and at loss too. So my goal by the end of this episode is to give people

a better understanding of how to support families and then also some practical tips and tools and resources that people can use to be able to step alongside this work with NICU families, whether you're a healthcare professional, doula, other support person, family member, loved one, whoever it may be. So let's start kind of let the audience know a little bit about who you are and what lets you to specialize in this work and a little bit about your story.

Ashley Inclima (02:22)
Great, thank you. ⁓ Yeah, so I am a birth and bereavement doula. It is something I am very, very passionate about. I'm a certified grief educator as well and really found my calling to this work based out of both personal and professional experience. I have experienced two pregnancy losses myself in 2011.

My first child, my son, his name is Adrian, was diagnosed with a very rare and fatal disorder in the second trimester. That led to me being offered two options, which was continue the pregnancy and wait for him to pass or interrupt the pregnancy with a termination for medical reasons.

I did go the route of a termination for medical reasons. ⁓ I worked in an OBGYN office at that time and it was part of a Catholic hospital system which meant that I was not able to use my provider who I worked with ⁓ or the hospital that I was employed by or my health insurance. ⁓ What I experienced was very

And

over time, I learned so much that hadn't been explained to me. ⁓ You know, being presented with, you know, this option or that option. I learned within both of those options were a whole lot of other paths. And it was really re-traumatizing.

as I learned these different paths within those options. know, ⁓ one of them being, had I not interrupted the pregnancy, say he was born alive for a short period of time, could we have donated his organs, right? ⁓ The setting for which I had my procedure, I did not know what that was going to entail.

Had I known that, I might have opted a different route, a different facility. ⁓ And it just...

It really sparked within me this drive to ensure that people are informed, fully informed about whatever they're experiencing. Not just for a situation as specific as mine, but you know, if someone finds out they're having an early pregnancy loss, the details and differences between opting for a DNC or expectant management at home, those look very different and often,

People are not informed of the very, very key differences there. Do they want genetic testing? You know, that's also something that can happen if they do expectant management at home, but they need to be prepared for that and given the right tools and things to make that happen. ⁓ yeah, so that just, that is something I'm very passionate about. ⁓ I did have an early five week pregnancy loss after my son.

and then I did go on to conceive my now living identical twin daughters, who I'm just so grateful for. But as I continued my work professionally in OBGYN offices, ⁓ as a technician on labor and delivery, and as a perinatal loss coordinator, I just, I want to do more. I wanted to do more. And when I went through my birth doula training, it was a

huge like come together aha moment. This is what this is what I've been looking for. This ability to hands on fully support people be that person to ensure they are receiving all the information that they have that emotional support that physical support that the postpartum support which is hugely lacking. ⁓ And yeah, that that led me to

you know, get into this work. And a really large part of that is also educating other doulas and medical professionals and families, loved ones on how to support families who are experiencing loss. I can be so isolating. And again, there's so many gaps. And I'm just one person, right? I can only support so many people just on my own. And I really want to contribute to creating some change.

and let's get as many people as educated as possible so we can really have that ripple effect.

Mary Farrelly (07:21)
I thank you so much for sharing your story. Ashley and I spoke a little bit before this podcast and the parallels between both our stories and our turning point moments and then the passion and the work that we do is there's such a mirror image and it's so I felt so like connected and aligned to be like we see the gaps, we lived gaps and now we're on this mission to help fill them and knowing that

A huge piece of that is education and the empowerment that comes from being able to have actually informed choices offered to you and seeing all the different holes where those opportunities were just, they were there and then they were gone. Whether the person that was there in that moment, a healthcare provider just didn't have their own training or understanding of options, or there wasn't that support person to help translate and help you find your words and your ability to advocate or process things.

There's so many steps along the way. And then it, it really comes down to being able to see that bigger picture too. Like there's just, like I worked as a NICU doula, you worked directly with families as a bereavement doula. There's just one us, but there's so much work to do. And there's so many people that want to do the work and they want to do it well, whether that's in the medical system or as a doula, people instinctively want to show up in a better way and are just simply do not have the training or the tools to do so. So I'm just so excited that you are

in that work and I'm also wanted to acknowledge and say that I'm so sorry for your loss too. I also lived many, many losses before my girls were born and thinking back as you were sharing about expected management, one of my losses was like a missed, like you know, the baby's heart stopped beating and I had to make a choice about whether I wanted to have a DNC.

or expected management at home and what that would look like. But again, like reflecting on that, my choice was very much like, just literally like a sentence. Here's option A or option B, but no background or understanding of like, what is that gonna look like? What do I actually want? And then there's this pressure to decide now, right? Like, which, you know, that's also sometimes force pressure too. ⁓ So I'm just, I'm excited to dive into.

Ashley Inclima (09:32)
Thanks

Mary Farrelly (09:40)
this topic today, because I feel like ⁓ it's just so needed and so limitless in the potential impact that this can have on so many people's lives. one of the things also with the work of a NICU doula is that we know we're not going to take away the hard, right? Like a loss is a loss. NICU is traumatic. Like there's elements of that, that having someone alongside you is never going to erase, but we can mitigate it. We can be that cushion to make it feel as

quote, good as possible or as aligned or as empowering as possible despite or maybe in spite of the unique situation that each person is in. So let's kind of talk a little bit about the NICU specifically, because I know that there is loss in, perinatal loss can come in so many different forms, right? And some of the themes and elements are the same. So let's actually start there. What are some common experiences or

or themes of grief or loss that you see show up along the full spectrum of perinatal loss.

Ashley Inclima (10:44)
Yeah, I, you know, I think of a big one, you know, sort of like you said, when options are being discussed and things are being explained and how you just reflected back and said, wow, it was just, I was given this or that. And that really just highlights the fact that when you're experiencing, you know, grief, loss, really whatever context, but especially, you know, perinatal loss,

⁓ You only have limited time, right? You only have this one chance to make these informed decisions. And when somebody is not fully informed and empowered with their choices, there can be a lot of guilt or regret later, which is also something nobody needs to ever carry. We do the best we can in the moment where we're at.

Mary Farrelly (11:19)
Mm-hmm.

Ashley Inclima (11:45)
and with the information we've received. And yet, I see that a lot. A lot of the reflecting back and the, gosh, I wish I had done this different, or I didn't realize that this memory-making opportunity or this thing ⁓ might have been really, really valuable down the road. And... ⁓

Again, mean, it just comes back to the being empowered and fully informed, but I think that's a really big one. ⁓ Also, this feeling of isolation. We really don't, we don't live in a grief-informed society. Okay? ⁓ There is a lot of pressure to move on, get back to normal, and we just receive these external messages so clearly and so strongly.

and the truth really is you never get back to normal. You don't move on and grief really needs to be witnessed. We need to be seen where we're at, have that validated, and have it be okay. And when it comes to specifically perinatal loss, child loss, infant loss, that's an out of order loss, right?

Mary Farrelly (12:43)
Mm-hmm.

you

Ashley Inclima (13:06)
We are not supposed to outlive our children and therefore it can make people really uncomfortable. It can make people really uncomfortable. And something that you also hear a lot in grief is, I can't imagine.

Mary Farrelly (13:21)
Mm-hmm.

Ashley Inclima (13:23)
And this is something that I really talk a lot about and teach is for some that might land just fine, right? But for others, that can feel really disconnecting because saying, can't imagine, well, I can, I'm living it. And you can imagine, but you don't want to, right? And that's a, it's a sympathetic response versus an empathetic response versus meeting someone where they're at.

Mary Farrelly (13:45)
Okay.

Ashley Inclima (13:53)
being able to sit and come from a place of understanding. And unfortunately, that doesn't happen a lot. Again, because people don't want to imagine they could lose their child too.

So it can just be so, so isolating and it can cause a lot of strain on relationships when people say insensitive things or say nothing. And a lot of people don't know what to say. They don't want to say the wrong thing. And so they do say nothing, right? This is, I don't know, this is a big part of this piece that I really love to talk about.

Mary Farrelly (14:05)
Yeah, we don't want go there.

Mm-hmm.

Ashley Inclima (14:32)
So people know, sometimes you also, don't have to say anything and you can still show up in a supportive, empathetic way. ⁓ Language and communication around these things is crucial.

Mary Farrelly (14:36)
you

So let's go there because I'm seeing for all the colleagues and people that I've worked with, whether you're a brand new baby NICU nurse and you're helping a family along with their very, their first loss. Like maybe this is your first time as a person experiencing or witnessing loss or maybe you're a doula and your client had an unexpected loss or you're a loved one and the instinct because as you said, we are such a grief.

Missing this missing piece of education. So many other cultures are really good at grief. Like they have this container or this almost like culture around allowing displays of grief and acknowledging it and really not treasuring it, but really like allowing it to be. And we don't. So if you are that person, what, and so many people do, they just simply don't say anything because they don't want to say.

right thing or you or we have these like canned hallmark sayings that we were taught culturally by probably our loved ones and people that were modeled to us and lost experiences and we're only working off of what we've seen. What would be like one to two maybe three things that people can say or do in those moments that would make a potential positive impact? What is that? What are those lines that people are like but what do I say or not say?

How do I do that?

Ashley Inclima (16:09)
Yeah, a big one is simply saying, you're not alone and I'm here with you. ⁓ Another one is, I see you. ⁓ Just offering validation, this is really hard. ⁓ You know, I also, like to use a lot of, I wish this wasn't happening. ⁓

Not that saying I'm sorry is bad, but people going through difficult times tend to hear a lot of I'm so sorry, I'm sorry, I'm sorry. And sometimes it can kind of bring this like if someone tells me one more time, they're sorry, right? So I like to, you know, I wish you weren't going through this. I wish this hadn't happened. And honestly, sometimes just silence. Sitting with someone in silence.

Mary Farrelly (16:55)
Mm-hmm.

Ashley Inclima (17:09)
is okay. You can still use your body language to show you care, right? Giving, just being present, giving them your attention, maybe holding their hand if they're open to that touch, maybe a hand on their back, a hug, right? Just simply being present and sitting with them in silence. Sometimes when people are going through a really difficult time,

They don't want to have to talk, but they don't want to be alone either. And you can just sit with them in that.

Mary Farrelly (17:44)
And that takes a lot of self-awareness and ability to process your own grief as the person showing up for a grieving person. Because I think some of that instinct to be like, I don't want to imagine is protective, right? You're trying to protect your own heart and your own mental status. And so it is such a gift to be able to take your veil off and let somebody in. And I know like as a healthcare provider, as an NICU nurse,

Ashley Inclima (17:59)
Yes.

Mary Farrelly (18:15)
That can be hard because you don't want to cross a professional boundary. You don't want to, you know you're gonna have to keep on showing up for different families maybe in the next hour or two. But the impact that you can have on a family by just like being still and being a human rather than just a healthcare provider in that moment is profound. And it doesn't have to be, you know, you're sitting next to this family for hours or.

depending on your role and your limitations, it's just those imprinting moments where someone was sharing that they experienced a loss and they had a NICU provider get down on their hands and knees, take off their mask by eye contact, and hold their hand and just say, thank you for letting me be a part of your baby's life. And she's like, that is what stuck, not all the other trite moments. And the harmful words stick too, unfortunately.

Ashley Inclima (18:58)
Yes.

Mary Farrelly (19:12)
thinking back to my own experiences too. So I think that's why people are also like afraid to say the wrong thing too. So it is hard. Like I just, I also want to acknowledge that it is hard as the supporting person. It's not clear cut. If it was, people would do it. ⁓ But we also aren't modeled it very well either. So I think that it takes people who are grief informed to be able to role model and almost like, like yourself, like guide people through this experience and through their own uncomfortable feelings.

Ashley Inclima (19:23)
this.

Yes.

Mary Farrelly (19:41)
so that we can be present for those in our lives that need us because it will happen and it might be your loved one, it might be your client, it might be someone in healthcare, but it will come, grief always comes. ⁓ So having those extra tools are so important. Let's talk a little bit, we reflected on it, what might make the inicule loss specifically in the context of all these other types of losses potentially unique.

There are, you the Nikke environment. It's one of the themes of this whole podcast is a, it's a weird place. It's a very unique space with its own language and norms and roles and sights and smells. it is, it can be very different for families too. So I don't know if you have any insight or experiences or just, guess, thoughts that you wanted to share on the unique nature of a NICU loss.

Ashley Inclima (20:36)
Yeah, absolutely. I mean, gosh, right? There's so many challenges with a NICU stay at all in the first place, right? And, you know, there's something called secondary losses. And I feel like that is a huge thing that people experience in just even a NICU stay, ⁓ definitely.

bereavement ⁓ after loss in the NICU of, you know, let's think of the context. Perhaps there's living children at home and the family has been missing key important moments, aren't able to be home with their other child as much. Maybe they've missed an important event with their family loved ones at home. That's grief. That's loss right there. Perhaps the...

the birthing person has their own health challenges. Maybe that was a contributing factor to the NICU part in the first place. That comes with grief and loss. ⁓ Just there's so many things that think the difficulties of tending to your home. Maybe it's also pets at home. ⁓ Maybe you had an anniversary.

and you know miss that like there's so many layers and Definitely that isolation that isolation of going through everything that happened throughout the time in the NICU often Families are going through that pretty singularly without a lot of their support people around ⁓ And there's grief tied to that right ⁓

Mary Farrelly (22:10)
you

Ashley Inclima (22:29)
Perhaps it was a really long NICU stay. There's just grief at every single step, watching perhaps their child having been in pain. NICU journey could have a lot of ups and downs. Perhaps, you know, there was a moment where it seemed things were gonna be okay, and then they weren't. There could be so much shock in there. There can be a lot of... ⁓

numbing. So you can have a lot of delayed grief because you're tending so actively to that situation. It's protective. It's how we protect ourselves. And so I think the grief can really come on very, very deeply and very, what can feel like abruptly because they've just been kind of in that survival mode.

Mary Farrelly (23:00)
Mm-hmm. ⁓

Yeah, is so much, as you said, the loss and the grief in a NICU state, even if it is a baby that they're taking home from the NICU, there's so many losses along the way. Whether, as you shared, the family is realizing that it's a loss in the moment, because most of the time families in the moment are in fight or flight freeze. Like they're in their core...

animal brain, like run away from the tiger mode. Like we are just getting through this. And especially if they don't have support for themselves too. And they are being that person for their baby. Some of it is like the loss of their birth and the loss of their pregnancy and their baby shower and their expectations, their loss of, know, one of the things I share in one of the workshops I do is like when people pee on stick and get those positive pregnancy lines, people are envisioning a very specific idea of what their birth is going to look like. And it,

Ashley Inclima (24:17)
Yes.

Mary Farrelly (24:18)
is not any element of the NICU's. know it's like, I can't wait for my baby to be on CPAP and in an isolette with all these tubes and wires and be separated from me. It's not even on the radar. So even up to that point, there's so much loss and processing that needs to happen along the way. If some of the people that will be listening to this podcast are NICU families.

who maybe are well past, maybe in the NICU journey themselves or maybe past it. So do you have any words or thoughts on how people who are recognizing that they are experiencing grief, maybe not specific to infant loss, but are experiencing grief? What words do you have for those NICU families that might be listening?

Ashley Inclima (25:05)
To give yourself grace, to give yourself grace that it is okay to feel however you are feeling. You sometimes we can judge ourselves harshly. ⁓ And there is no right or wrong way to grieve. However you are grieving, however you are feeling, that's what's right for you. And you can allow that. We don't have to

expectations on ourselves. We don't have to carry guilt for, you know, maybe, right, maybe feeling guilty about being disappointed the birth aspect didn't go as planned. Maybe there was trauma associated and, you know, or maybe a hope for a home birth and that didn't happen. You can grieve that. It's okay to grieve every part that feels painful. ⁓

And so yeah, just giving yourself that grace and kindness, it's okay to feel however you feel.

Mary Farrelly (26:10)
I love that. feel like what I often see, similar to what saying, there's specific things that are said to families that are experiencing loss that may be well intended but are ultimately harmful because they don't allow people permission for real feelings. For NICU families, what I see oftentimes is this forced toxic positivity and forced optimism, those at least statements, know, like, at least my baby's home, at least, you know, I'm in a good NICU, at least blah blah blah, and people are...

Ashley Inclima (26:29)
Yes.

⁓

Mary Farrelly (26:39)
are saying that to them as families and families are also often telling themselves this like I am not allowed to feel.

these maybe yucky feelings because I need to focus on gratitude. And gratitude is important and we don't, we want to be able to balance one of the missions of working as a NICU doula is balancing joy, bringing joy into the Nikky experience, even at midst and among the grief and loss, trying to find those pockets of celebrating your parenthood and your baby and their life and the beauty of the miracles that you're experiencing, whatever that might look like for a family. And also

acknowledging that you can still be mad. You can be really mad. You can be sad. You can be mad. You can be mad, sad, happy, angry at all at the same time. And that's okay. And you're allowed to say those things out loud. A lot of times I feel like we stuff, stuff, stuff, stuff, stuff. And families are like, you know, I'll deal with this. when they deal with it, and that's okay too. That's survival, but it will come, right? It will come too. So giving yourself grace and knowing that they're all.

Ashley Inclima (27:16)
Yes.

Yes.

Yes.

this.

Mary Farrelly (27:43)
relevant and sacred and important and you are a person. You're allowed to feel things. So you're not just a parent or a mother or a caretaker. You are a person and you're allowed to have your own lived NICU experience as well alongside your child.

Ashley Inclima (28:00)
Yes, that's, life is all about duality. You know, on top of, you know, us not living in a society that really talks about or honors grief, we also don't acknowledge the duality that exists everywhere. Like you said, it's, know, ⁓ are you nervous or are you excited? Are you scared? Right, it's or, or instead of and. And that's exactly, you can,

Mary Farrelly (28:04)
Mm-hmm.

Mm-hmm.

Ashley Inclima (28:29)
Be very grateful and deeply grieving an aspect of your journey. It can be both. And yes, hold that. No, that's okay. This and that.

Mary Farrelly (28:39)
you can't eat with me.

Mm-hmm. Yeah, the black and white duality is so pervasive and the one people that do get this is like my my young children they watch Daniel Tiger and there's a whole song about how you can be more than one thing as a person and as a feeling and it's so beautiful to watch side tangent, but my When my not she's six now when when she was four my daughter was like I'm nervy sided like she made up her own hybrid feeling

Ashley Inclima (28:53)
Yes!

Mary Farrelly (29:11)
And I loved us, like, you are so smart, like we need to be learning from them. ⁓ But that they are just, they're gonna be the future generations. There's so much hope for how they're gonna be experiencing their postpartum and perinatal experiences. But ⁓ we're not there yet. We're working on it. We're doing the work. We're lighting, we're guiding everybody along the way. ⁓

Ashley Inclima (29:23)
Yes.

Yes. See you all sometime.

Mary Farrelly (29:37)
So one of the things also that I wanted to touch on today is tangible support of memory making keepsakes, allowing those options, like talking about what are some options that people might not know about or even healthcare providers might not know about for allowing for more ritual memory making keepsakes. ⁓

those like, again, bringing more humanity in individualized care to a loss, especially because we're talking on the NICU about NICU loss, but also in general too. Because these are also people just feel like because we don't think about and don't talk about it, when you're in it, you don't even, right, you don't know what the options are. You just make these rash decisions and then you look back on them and you have these coulda, woulda, shouldas, So let's talk a little bit about maybe some.

practical things or tools or resources that you can share to help support families in more of a tangible, practical way.

Ashley Inclima (30:39)
Yes, I like this topic. As we talked about earlier, this is the only chance families have to make these memories, to receive mementos. mean, handprints, footprints, maybe a molding of a hand or a foot. Photography, photography.

taking photos, as many photos as possible. You can always delete photos, right? ⁓ And also some families may not think that they want photos, but we should take them anyway and create a situation where, here are these photos. You don't have to ever look at them. You don't have to ever look at them. But there might come a time where they want them.

and you can't go back and take them. So having those photos, there's a really, really lovely organization called Now I Lay Me Down to Sleep, fabulous nonprofit. They will come in and take photos for families free of charge. They'll also retouch photos for families. So whether they provide a photographer for that, you can submit photographs to them for retouching, which is just so lovely. ⁓

and taking photos of sensitive moments. I have heard so many times that some of the family's most treasured photographs are the ones that are the most raw, where they're really displaying their grief, holding their child, crying, just sometimes those are the best photos. So not shying away from those. ⁓

Maybe the blanket their baby was wrapped in or a hat. ⁓ You know, the crib card with the baby's information and allowing as many parenting opportunities as possible. Maybe they want to bathe their baby. Maybe they want to read a book that they had special for their child. Maybe they want to sing to their baby, hold their baby, right?

allowing as many parenting moments as possible. Again, this is the only chance that they get and to really go through all of those options. Sometimes families need that permission. ⁓ They wouldn't think of these things. I supported a family that ⁓ baby was born early, lived for a few hours and I asked, would you

Would you like to bathe your baby? And this mom looked at me and asked, you know, I can do that? I said, yes, yes, you can do that. And she sponge bathed her baby and she smiled through the entire process. And honestly, that's that was, huh, that was one of the most profound moments I've ever experienced to to see that. ⁓

Mary Farrelly (33:53)
Thank

Ashley Inclima (34:01)
to watch her love and care for her child. you know, families just, they don't know. So we need to let them know all of the options and give them the permission to do these things. ⁓ It's really so important.

Mary Farrelly (34:08)
Mm-hmm.

I think that's a moment of joy, right? Like that's that micro moment amidst the and, amidst all the grief and the intensity of the moment, she was able to find that pocket.

of a positive moment with her child that will impact her for a very long time. One of the couple other things I wanted to mention with my own experiences supporting families with loss where I think things went, the ones that really stick out, right, that are like this.

was really hard, but it was good. Like we did that this was okay. ⁓ Was really, and you're not always able to do this. Sometimes loss in the NICU is very acute and very quick, but oftentimes it's not. Oftentimes it is this moment in time where families, we've done everything that we can, ⁓ or and the baby's actively passing and we're now transitioning to comfort care, end of life care. And it can be a slower process too. So asking families,

Who do they want there with them? Because that's not even often. They don't know. they're, especially in the NICU, there's very strict visitation policies and procedures for lots of NICUs. And they don't even know to ask, can I bring in my children? Can I bring in my parents? Can we all be in this space at the same time? Sometimes it's also advocating for a different setting. That's again, not always possible, but it sometimes, the hospice can get creative sometimes and it's

Usually not offered. It's usually a conversation and being asked sometimes we've opened a window before illegally Sometimes we've been able to take a baby outside for a period of time before Being in a more private medical space. Sometimes we're able to bring in, ⁓ you know religious

Ashley Inclima (36:00)
You

Mary Farrelly (36:12)
people in that person's life that are really meaningful have full, some rooms are filled with people and it can be beautiful. It can be tracking to navigate as a healthcare provider, but it's beautiful because this family is witnessed and supported and they have a different level of memories. Another thing that's also often families aren't thinking of, I've been in losses where it's so quiet.

And sometimes that's exactly what the families need. Sometimes if I offer, you want music playing right now? Do you want to be like, what do you want to listen to? What do want your baby to listen to? It just changes the tone in a room entirely. And she might have a specific song or lullaby or worship song, whatever it may be. ⁓ And then also videos, too, because pictures are so impactful and so needed. But some families want to.

have this tangible memory with they may not never again never want to see it but they may want to have more videos of their child alive with them or have them especially with that redirection or have that video of them singing a song or the video of the bass so there are ⁓ especially if there are siblings that come before or after these babies

Siblings love, they love videos and that really helps them process ⁓ and appreciate their sibling that may no longer be Earth side. I think that there's, they all seem so simple, right? But the impact is again, really, really beautiful. And those mementos and memories are a legacy and they really, they, they echo onward too. And I do also love, now I lay me down to sleep.

And as a NICU provider, it can be helpful to know, because they're not always available in the moment, how to take a picture of yourself and also know then that you don't have to be a photographer. You can then go back to people and have them make it look more professional or more. But it doesn't mean you shouldn't be taking the pictures. If you're like, I'm not good at it, too bad. Take the picture with permission and also including the families as much as possible. And sometimes that might mean

Ashley Inclima (38:16)
Yes.

Mary Farrelly (38:22)
really opening the door wide because sometimes families, especially dads and non-birthing people, sometimes are like, they're so uncomfortable with their own grief or not wanting to step in on their partner or the mother's grief that they're not allowing themselves to be in that space at all too. And so sometimes opening the door really wide and inviting those people in too ⁓ can really be really powerful as well because everyone has their own.

kind of way of navigating it and partners and siblings often get kind of left behind in a certain way. So, thank you for sharing.

Ashley Inclima (39:00)
I

also, like to talk about the rule of three, which is asking, offering options three times, not more. But sometimes just once isn't enough. You ask or offer, would you like to, again, maybe bathe your baby, hold your baby, or whatever the thing may be. And if they say no, or I don't know,

Mary Farrelly (39:05)
Mm-hmm.

you

Ashley Inclima (39:30)
One, validate that. ⁓ And then ask again. Their feelings might change. ⁓ Or again, often there's a I don't know. They need to sit and absorb what has been offered. But if you get to three and the answer hasn't changed, it is a no or I don't know, then leave it because you also don't, you don't want families to think they should, right? so I should be doing this.

Mary Farrelly (39:55)
Mm-hmm.

Ashley Inclima (40:00)
No, whatever you decide in the moment is you're doing the best that you can, right? ⁓ But offering more than once can be really helpful to just allow for that processing. ⁓ And also recording the heartbeat.

Mary Farrelly (40:10)
you

Mm-hmm.

Ashley Inclima (40:17)
That's another really, really lovely type of memento that people can take. I've seen it recorded and put inside a teddy bear.

Mary Farrelly (40:26)
Yeah, those are so special. The teddy bears and then especially the teddy bear can then be the same weight as the baby. We have ways of doing that. ⁓ Printing out an EKG strip. Sometimes people, you know, sometimes people virtualize their baby through tattoos and having like a tangible item that they can use to then model whatever their way to memorialize their baby ⁓ might look like. And a lot of times that

Ashley Inclima (40:31)
Yes.

Mary Farrelly (40:52)
these mementos turn into some sort of like very tangible keepsake that sometimes are very displayed in people's homes and are like, here's our child. So as someone who's in that space, remembering those, because a family again, is not going to know to ask for things, or they might, but remembering as a doula, making sure that you have an idea of what different resources are available in different settings. I will say most. ⁓

NICUs and LNDs have some sort of perinatal loss program and have like a toolkit, like a memory making toolkit that the providers can use. But sometimes it might also be like, what's special for that family? Like what sort of keepsake do they?

really really want. I had one family make a bracelet and one went with the baby and one with the mom and one with the sister. So was like this tangible connection which was just like so simple but also like a tangible way to have this chain. was really really very beautiful.

So we talked a little bit about healthcare providers and families. And I know that both of us work very closely with doulas and other support professionals who play a different role, right? You're really, you're not maybe doing the memory making as specifically depending on the setting, or maybe you are not.

as always in the exact space. Maybe you're in the general vicinity and you are supporting a family whether it's expected or unexpected. What suggestions or insight do you have for those non-medical but still essential support provider roles like doulas?

Ashley Inclima (42:27)
Yeah, there's so much practical support that can be done. A big one, which I think people are pretty good about thinking about is meal trains, starting a meal train. ⁓ There's assisting with care for children at home or pets at home, of course. But there's also a lot of other ways that you can really help lighten load.

Mary Farrelly (42:37)
Mm-hmm.

Ashley Inclima (42:53)
practically for families. Often, for instance, there's a lot of paperwork for maybe it's leave from work or for insurance purposes. ⁓ You can help fill out those forms, right? Names, addresses, ⁓ phone numbers, dates, ⁓ maybe helping make a phone call to find out the process for submitting a form for them.

Mary Farrelly (43:12)
Thank

Ashley Inclima (43:24)
⁓ That, you know, it's all of those little tasks that add up and can really add to the burden. So any little practical thing like that. ⁓ Maybe making a call to the funeral home and asking some questions. You know, just a lot of those sorts of practical things help with the housework, pick up their groceries.

Mary Farrelly (43:32)
you

Ashley Inclima (43:52)
Maybe they need a medication filled, pick it up from the pharmacy. All of those small tasks being taken off their plates can just be so, so supportive and helpful.

Mary Farrelly (44:06)
Yeah, and it really allows families to be present and not have to automatically flip into this micro managing role that they have to play to keep life going because life is still continuing on, especially with other children and pets and people who depend on you for their own needs, being able to alleviate some of those. And I love that paperwork piece. That is a huge burden. So even if you can just organize it all in a Google Doc.

here's the direct links, here's the phone numbers, I did all this research, all you have to do is sign these papers. wow, like that just saved them hours of their time and these moments where don't have to be professional and like act a way that you're maybe not feeling in that moment. So again, seems simple, but so, so impactful and meaningful.

Ashley Inclima (44:53)
Yes.

and to know as a support person that you don't have to take on all of those things yourself. It's about helping delegate it. know, call in all of the support people. Maybe one person can handle this thing and another person handles that thing. You know, it's the collective. You know, it takes a village. And so also know as somebody supporting someone, you also don't have to take on every aspect of what that support looks like.

Mary Farrelly (45:21)
Yes.

Yeah, you don't want to burn yourself into the ground to be able to lift someone up. Like it's just not gonna, you're gonna be needing your own village to get yourself back to baseline as well. So yeah, delegating research. I do feel like in these types of crisis modes, it's helpful to find that person whose love language is project management. And because everyone has their own way that they want to show up and grieve. Some people are really, really good at supporting someone emotionally. Some people are really, really good at that practical support and terrible emotional support.

Ashley Inclima (45:32)
That's right.

Yes.

Mary Farrelly (45:53)
others are really good at food and doing the thing. so really almost having that like powwow meeting hub. And so then everyone can kind of do their, their work, do their, what they're best at to be able to help the person in the middle of the family, the hub in the middle too. So as we're kind of wrapping up our conversation for today, I

we'll get to where people can find you, because I know that as people are listening, people are like, my gosh, Ashley is amazing. I want to know more. But for people who are showing up and helping families through loss, what is the one small thing, what is the one takeaway that you want people to have as they are listening to this and thinking about how they want to show up for a loss of somebody down the road?

Ashley Inclima (46:47)
Hmm. One thing. Okay. All right. Gosh, is, woof. That's that's a challenging one. Yeah.

Mary Farrelly (46:49)
I know.

No wrong answer here. You've already

given so many beautiful takeaways.

Ashley Inclima (46:58)
Gosh, the one thing...

Witness their grief. Witness their grief. Don't shy away from it. ⁓ If you're unsure what, if you're unsure if something you're doing is helpful or not helpful, also just ask. You can ask them. But just sit with them in their grief without expectation, without pressure.

and just know that your presence is enough. ⁓ Use their child's name, set a reminder in your phone for key dates, and it's as easy as a text, I'm thinking about you.

Mary Farrelly (47:46)
It's the witnessing, the remembering, the holding space, and especially what I've heard over and over again from people who have lost a child is that they don't want their child's name to be forgotten. They don't want their child's life to not have had a meaning or an impact. And so that just comes down to remembering and allowing the loved, the mother, the bereaved parent to talk about their child and to talk about their experience.

Ashley Inclima (47:48)
just.

Mary Farrelly (48:12)
and not feel like they're not allowed to or that they just have to move on or be strong or whatever. Things that we kind of tell everyone in our society to stuff it down and get back on. But allowing people just be. To simply be. So thank you so much for sharing your beautiful wisdom and your words. You have such a very calming, lovely way of expressing yourself and I feel like you are doing the work you are meant to do. So it's so special to see people

Ashley Inclima (48:32)
you.

Thank you.

Mary Farrelly (48:42)
living out their purpose and ⁓ yeah, turning pain into purpose really and living it, living in a way that you're shining your light into so many of those like dark corners that don't get a lot of light. So thank you for being here. But what offers do you have? What resources, what tools, where can people find you and learn more about bereavement and supporting families who lost?

Ashley Inclima (49:05)
Yeah, definitely at my website which is tidesoflifedula.com, social media, Facebook, Instagram, ⁓ at tidesoflifedula. ⁓ I do have a self-paced course available ⁓ on supporting people through perinatal loss. And I also offer one-on-one grief support, ⁓ virtually, mostly actually, so really doesn't matter where anyone is.

meeting once a week and just holding space for them in their grief and offering tangible tools and resources. But yeah, so a lot of that on my website and you know, I do this work because I'm passionate about it, right? And I am always happy to be here as a resource for anybody. know, reach out to me. It's not about hiring me for my services or you know, purchasing my online course.

you or someone you know needs some resources, reach out. I will always respond with an email. I will always help guide to any type of resources support that somebody is needing. just, yeah, I'm here. I'm here to help.

Mary Farrelly (50:21)
You are the doula. You are here

to doula the other doulas and everyone together. I feel like the work of a doula is to hold space and connect with resources and come up, allow people to get to like that next best step with our next best step. We don't need to, and I'll be there alongside you. I'm not gonna do it for you, but I'm gonna be there alongside you and you perfectly embody that. So thank you so much for being on the show today. And I'm so excited to continue to watch how you're.

Ashley Inclima (50:44)
Thank you.

Mary Farrelly (50:50)
grows and impacts people all over the world.

Ashley Inclima (50:53)
Same to you, Mary. Thank you so much. I ⁓ really enjoy these conversations with like-minded people and people who are also working from their heart and out of a place of passion and helping others. I'm so glad we met and it's just lovely talking to you every time. Thank you.

Mary Farrelly (51:13)
Thank you.